Does L02.91 require prior authorization?

No, L02.91 does not require prior authorization (high confidence). Code is covered without prior authorization.

`L02.91`, Cutaneous abscess, unspecified

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

When routine foot care needs to meet one of the exclusions, include the applicable Q modifier on the claim: Q7 for 1 Class A finding, Q8 for 2 Class B findings, and Q9 for 1 Class B plus 2 Class C findings.
For all foot-care claims report an appropriate foot/toe location modifier (e.g., LT, RT, TA, T1-T9) to identify laterality and specific toe when applicable.
If a significant, separately identifiable evaluation and management service is provided on the same day as routine foot care, append modifier -25 to the E/M claim line.
Total the number of keratotic lesions debrided and select the most appropriate CPT code 11055-11057 based on that total (example: code 11056 for two to four lesions).

Removal of corns and calluses of the feet must be billed using CPT codes 11055-11057 (paring/cutting of benign hyperkeratotic lesion) and the procedure code that most accurately describes the service performed should be reported.
MolecuLight, a hand-held device, for point-of-care fluorescence imaging of wounds
Noncontact, nonthermal, low-frequency ultrasound therapy for the treatment of wounds and all other indications (e.g., bacterial infections, deep tissue pressure injury, and femoral artery thrombosis)
Warm-Up Active Wound Therapy, also known as noncontact normothermic wound therapy (NNWT) and warming therapy
None — The CPB states the following are considered experimental and investigational because effectiveness has not been established: MolecuLight (hand-held device) for point-of-care fluorescence imaging of wounds; noncontact, nonthermal, low-frequency ultrasound therapy for the treatment of wounds and all other indications; Warm-Up Active Wound Therapy (noncontact normothermic wound therapy / NNWT / warming therapy).
Coverage may be allowed when the patient has Amyotrophic Lateral Sclerosis (ALS) resulting in a need for routine foot care.

NOVITAS-JH-L35138, Routine Foot Care

NOVITAS-JL-L35138, Routine Foot Care

A52996, Billing and Coding: Routine Foot Care

AETNA-CPB-0372, Wound Imaging and Noninvasive Wound Therapy

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